Gender and Racial Differences in Stress, Coping, and Health-Related Quality of Life in Chronic Kidney Disease

Abstract

Objective Health-related quality of life (HRQOL) is an important outcome for patients living with chronic kidney disease (CKD), and it is necessary to better understand potential gender and racial differences as well as predictors associated with reduced HRQOL so effective interventions can be developed. Methods Participants included 182 patients with CKD who were administered a battery of questions that included the Medical Outcomes Study-Short Form 36; Perceived Stress Scale, and the Brief COPE. Demographic and disease specific information was abstracted from the patients’ medical record. Results No differences by race were observed with regard to stress, quality of life or coping with the exception that minority patients reported use of religious coping more often (p=0.001) and had higher levels of energy when compared to non-minority CKD patients (p=0.27). Women with CKD tended to use self-distraction (p=0.002), positive reframing (p=0.035), venting (p=0.024), and religious coping (p=0<0.001) more often than men. No significant differences in perceived stress or domains of quality of life were observed between men and women with CKD. A link between coping strategies and HRQOL was observed in women (p=0.001–0.02) but not men. Perceived stress was associated with poorer quality of life for men (p=0.017–<0.001) and women (p=0.001–<0.001), but more domains of men’s quality of life were affected by perceived stress when compared to women. Conclusions The findings of the study suggest that the wider range of coping strategies used by women may be associated with buffering the link between perceived stress and quality of life. Men with CKD may benefit from interventions that not only reduce stress but also facilitate the use of a broader range of coping strategies to reduce stress and improve quality of life.

Perceived Discrimination and Longitudinal Change in Kidney Function Among Urban Adults

“…(55) Moreover, both racial and gender differences in coping with psychosocial stress, including discrimination, are important to consider, as they were detected in various non-CKD samples, and coping strategies have been noted to vary among men and women with CKD, with women showing a broader range of strategies that can buffer the effects of stress. (56)…”

Relationship between stress coping strategies, psychological distress, and quality of life among hemodialysis patients

“…Recently, Gemmell et al. evaluated 151 dialysis patients and found that the wider range of coping strategies used by women may be associated with buffering the link between perceived stress and quality of life . In another study, Saracho‐Rotaeche found avoidance and adaptive mechanisms are coping strategies that influence the psychological well‐being of dialysis patients…”

Assessment of quality of life in patients undergoing hemodialysis using WHOQOL-BREF questionnaire: a multicenter study

“…This result is in line with studies by Saad et al and Gemmell et al In both of these studies, the investigators found no significant difference in QOL scores between males and females. 6,25 Nevertheless, several studies have reported a significant influence of gender on QOL. Sayin et al documented males to have worse QOL than females, whereas Valderrábano et al reported the opposite.…”